Microdosing psychedelics and the risk of cardiac fibrosis and valvulopathy: Comparison to known cardiotoxins
Journal of Psychopharmacology – January 12, 2024
Source: OpenAlex
Summary
Microdosing psychedelics, popular in psychology, carries unknown long-term cardiac health risks. Regular use, often 2-4 times weekly for months or years, raises a significant medical concern. Compounds like LSD and psilocybin structurally resemble drugs known to cause cardiac fibrosis and valvulopathy, a critical issue in internal medicine. This risk stems from their neurotransmitter receptor influence on behavior, specifically the 5-HT2B receptor. Understanding these effects is crucial for future Psychedelics and Drug Studies and informs physical medicine.
Abstract
Though microdosing psychedelics has become increasingly popular, its long-term effects on cardiac health remain unknown. Microdosing most commonly involves ingesting sub-threshold doses of lysergic acid diethylamide (LSD), psilocybin, or other psychedelic drugs 2–4 times a week for at least several weeks, but potentially months or years. Concerningly, both LSD and psilocybin share structural similarities with medications which raise the risk of cardiac fibrosis and valvulopathy when taken regularly, including methysergide, pergolide, and fenfluramine. 3,4-Methylenedioxymethamphetamine, which is also reportedly used for microdosing, is likewise associated with heart valve damage when taken chronically. In this review, we evaluate the evidence that microdosing LSD, psilocybin, and other psychedelics for several months or more could raise the risk of cardiac fibrosis. We discuss the relationship between drug-induced cardiac fibrosis and the 5-HT2B receptor, and we make recommendations for evaluating the safety of microdosing psychedelics in future studies.